| Friends Of The Shattuck Shelter | |
|
170 Morton St Jamaica Plain MA 02130-3735 | |
| (617) 983-0351 | |
| (617) 971-9339 |
| Full Name | Friends Of The Shattuck Shelter |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 170 Morton St, Jamaica Plain, Massachusetts |
| Authorized Official Name and Position | Deborah Putnam (DIRECTOR OF PROGRAM DEVELOPMENT) |
| Authorized Official Contact | 6179830351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Friends Of The Shattuck Shelter 170 Morton St Jamaica Plain MA 02130-3735 Ph: (617) 983-0351 | Friends Of The Shattuck Shelter 170 Morton St Jamaica Plain MA 02130-3735 Ph: (617) 983-0351 |
| NPI Number | 1497897250 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497897250 | NPI | - | NPPES |
| 1302311 | Medicaid | MA | |
| 000000020458 | Other | MA | BMC HEALTHNET |
| 1028790 | Other | MA | BEACON HEALTH STRATEGIES |
| 1302311 | Other | MA | VALUE OPTIONS (MBHP) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0796 (Massachusetts) | Primary |
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